| National Provider Identifier [NPI]: | 1629089370 |
| Last Name Of The Provider | NELSEN |
| First Name Of The Provider | MIHOKO |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 E HAWAII |
| Street Address 2 Of The Provider | |
| City Of The Provider | NAMPA |
| Zip Code Of The Provider | 83686 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 252 |
| Number Of Medicare Beneficiaries | 182 |
| Total Submitted Charge Amount | 52502 |
| Total Medicare Allowed Amount | 33757.25 |
| Total Medicare Payment Amount | 21373.52 |
| Total Medicare Standardized Payment Amount | 21282.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 252 |
| Number Of Medicare Beneficiaries With Medical Services | 182 |
| Total Medical Submitted Charge Amount | 52502 |
| Total Medical Medicare Allowed Amount | 33757.25 |
| Total Medical Medicare Payment Amount | 21373.52 |
| Total Medical Medicare Standardized Payment Amount | 21282.99 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 106 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 101 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 45 |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 132 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5128 |